Concluded Case

Mononeuritis multiplex- polyarteritis Nodosa

A 53 yr old ,M,is seen in the clinic for new onset wrist drop rt side about a week ago. Two weeks prior to this ,he also developed a left sided footdrop that has persisted since then. Examination shows rt wrist weakness with finger extension and sensory loss in the dorsolateral aspect of rt hand ,along with left ankle dorsi flexion and eversion and weakness and sensory loss in the left dorsal foot and lateral calf. Which of the following rheumatoligical diagnosis is most likely to cause this presentation ?. A Behcet syndrome B Polyarteritis nodosa. C Sjogren syndrome D Takayasu arteritis

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Case Conclusion Thanks for all answers. The correct answer is B Polyarteritis nodosa.This patient's clinical presentation is most consistent with a mononeuritis multiplex affecting tge rt radial nerve and left perennial nerves.Mononeuritis multiplex can be seen in the context of a number of different rheumatological conditions but is most commonly associated with systemic vasculitides ,including polyarteritis nodosa , in which it is often the presenting manifestation .This patients mononeuritis multiplex is the presenting manifestation of PAN.

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C -,Sjogren"s syndrome . Incidence of neurological manifestations in Sjogren's syndrome are 10 - 60 % . Although- most common is pure or predominantly sensory polyneuropathy but less common manifestations are mononeuritus multiplex , polyradiculopathy etc

Case Conclusion Thanks for all answers. The correct answer is B Polyarteritis nodosa.This patient's clinical presentation is most consistent with a mononeuritis multiplex affecting tge rt radial nerve and left perennial nerves.Mononeuritis multiplex can be seen in the context of a number of different rheumatological conditions but is most commonly associated with systemic vasculitides ,including polyarteritis nodosa , in which it is often the presenting manifestation .This patients mononeuritis multiplex is the presenting manifestation of PAN.

C sjoren syndrome Steroid 6 to8 week 1mg per kg body wt

B Polyarteritis nodosa

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